Welcome! Blood, guts, trauma, surgery, and life saving intervention keep us on the adrenaline roller coaster of the ER. Of course, it's not always positive. The ER can be an emotionally taxing and sometimes heartbreaking workplace, and this blog serves as an outlet for the stress of making life and death decisions each and every day.

Monday, March 11, 2013

It's taken me a few shifts to gather myself to be able to write this story. That's how angry I was.

Two clients arrived with their 10 year old pomeranian. The presenting complaint was difficulty breathing; it was easy to see at triage that "Syclla" was breathing too quickly and too hard. Her mucous membranes were pale, and she was definitely ill, but still able to walk and wagging her tail. My technician asked for permission for immediate emergency treatment and diagnostics, which was declined. We placed Syclla in an oxygen cage and I immediately went to talk to the family.

"Hi, I'm Erdoc, and I'm sorry to meet you at such a difficult time. What's been going on with Syclla the last few hours?" I started to ask the pertinent questions that are vitally important for a patient history and to help sort out the more likely conditions.

The husband and wife (both in their late 40s) were immediately rude. As hard as I tried to be compassionate, kind, and understanding of what is never an easy situation, they remained cool, crispy and unfriendly. Their answers were short and their attitudes impatient. Certainly I respect that different people grieve differently, so despite their attitudes, I moved on to my recommendations for their pet.

Just like any other case, I gave the clients the findings based upon my exam, and options for diagnostics (to figure out what's wrong) and possible treatment options (which would depend on what's wrong).

"Our dog is old. Don't you think this is a bit ridiculous? She's 10 for god's sake."

"I certainly agree that Syclla is older. I understand if you don't think testing or treatment is in her best interest. I meet different kinds of people all day long, and so I just want to make sure you understand the options, the risks and benefits of each option, and make a choice that's best for you and your dog. Certainly euthanasia is something we never want to go through, but is a understandable choice in this situation, and if you felt it was right, I would support your decision."

The clients asked me to leave while they talked. When I returned, they had made the final decision for euthanasia. I told them that I supported their choice 100% and I was sorry for their hard day.

The euthanasia was smooth and painless; the clients held Syclla in their arms as she passed.

After she was gone, I again expressed my sympathies for their loss. "I'm so sorry you had to say goodbye. Take as much time as you need, and whenever we can help you with anything just ----"

The husband stopped me in mid-sentence by putting his hand (open palmed) 1 inch from my face, effectively telling me to shut up and definitely the most disrespectful thing that any client has ever done to me.

It took all of my professionalism, grace and restraint to walk out of that room and shut the door without saying or doing anything I would have regretted later. I'm still angry about how much emotional energy I spent trying to be kind, caring and compassionate only to have my kindness returned with disrespect.

All stories contained within this blog are inspired by my life as an emergency veterinarian. Details including but not limited to name, time of visit, species, and age are changed to protect the innocent and crazy alike. Any relationship to persons or animals, living or dead, is purely coincidental.

This isn't web DVM....

These stories are shared to inspire and to entertain. They are not intended to be medical advice. If your pet is sick, the only rational thing to do is have him or her seen (in real life) by a veterinarian.

Who is that masked woman, anyway?

Ever since I was little, I always had the dream of becoming a veterinarian. The dream has been realized, and my passion is emergency medicine. ER work has many pitfalls and disadvantages, but for me, the ability to be there in a moment of crisis and help both a beloved pet and their loving family, is worth the bad days.

Reliable veterinary info on the web

Followers

Definitions and commonly seen conditions

Anemia: Low PCV (see below). Anemia can result from external hemorrhage, internal hemorrhage, destruction of blood cells in the body, or inability to make new blood cells in the bone marrow.

Azotemia: Elevation in the BUN (blood urea nitrogen) or creatinine. BUN and creatinine are body wastes typically eliminated by the kidneys; increased levels in the body indicate kidney dysfunction, obstruction of urine, or severe dehydration.

Congestive Heart Failure (CHF): Accumulation of fluid in the lungs due to failure of the heart. Some symptoms include shortness of breath, decreased appetite, rapid breathing rates, coughing, and weakness.

Feline Lower Urinary Tract disease (also called feline idiopathic cystitis): A condition resulting in frequent, painful urination, and in the most severe cases, obstruction of the urethra. FLUTD has several potential causes and is also an extreme emergency.

GDV: Gastric dilatation and volvulus. Occurs in large breed dogs; the stomach fills with gas and twists. An extreme emergency, this condition is treated with stabilization and immediate surgery.

PCV: Packed cell volume. The percentage of red blood cells contained within a given sample of whole blood. Normal for dogs and cats is typically 35%-45%.